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Special enrollment period helps small biz get health coverage

By Terry Savage, Tribune Content Agency on

Health insurance for small businesses has become problematic in this staggering economy. Traditional plans require employers to contribute to the cost of premiums and require participation rates that are now difficult to meet amid layoffs.

That’s why this year’s small group special enrollment period running November 15 through December 15 is especially important. Even businesses with as few as two employees — and only one plan participant — can switch to a great group plan with no employer contribution required. And the employee can pay the premium on a pre-tax (salary deduction) basis.

This special deal is courtesy of the Affordable Care Act, which mandated small businesses have a once-yearly chance to set up a plan offering the same comprehensive coverage as the generous plans negotiated by large businesses in your state. During this period, all insurance companies that are selling plans in your state, on or off the health care exchanges, must agree to accept all small businesses that apply for coverage.

Why does this come as a surprise? Few insurance agents are pushing these plans, because they are a nuisance to the insurers and don’t generate big commissions for the agent. So it’s up to you — the small business owner — to ask for this coverage.

Here’s how this small business insurance deal works:

—Dates: Businesses must apply between November 15 and December 15. The plan becomes effective January 1, 2021.

 

—Qualifications: Businesses can set up a plan even if only one full-time employee joins. So, if some employees are covered by a spousal plan, a less expensive ACA plan or Medicare, and only the business owner wants this coverage, the plan is qualified.

—Coverage: The plan must offer equal coverage as group plans for large businesses in the state. Generally this means access to a wide network of hospitals and physicians.

—Premiums: The monthly premiums must be comparable to those offered to traditional small group plans. The employer is NOT required to contribute. Any employee joining the plan can pay premiums on a pre-tax basis.

—Pre-existing conditions: There are no limitations, because of the provisions of the ACA.

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